Emergency Room Series: Complications From Being A Product Of AS+AS

A boy in his late teens was brought to the ER yesterday by his mother. He was in painful distress and was groaning. The mother said he was a sickler and was in his room for an unusual long time that morning and he wouldn't come out. 

When she went to check on him, she met him on the floor, rolling in pains with an obvious erection that wouldn't go down.


The doctor on call asked him if it was the first time it was happening, he said yes. The doctor then asked how long it had started and he said about four hours. When we asked him why he didn't report to his mother, he simply said he thought it would go down.


On physical assessment, he looked smaller than his age in size. His eyes were a bit yellow. We checked his vitals which came out to be normal. We took blood samples to check his blood level as well as other tests, his blood level was 30% which was within normal limits for a sickler. He was diagnosed with Priapism.


Normally when a man gets aroused, the arteries in his p*nis relax and expand, bringing more blood to the penis. At the same time, the valves in the veins close, trapping blood in the area and causing an erection. After the excitement ends, the vein valves open, the blood flows out, and the p*nis returns to its usual state. In the case of this guy, it was the other way round. He claimed he wasn't aroused but only woke up to a sharp pain in his penis and an erection that wouldn't go down. Priapism is a common complication in men that are sicklers


At first we put up IV fluids and we placed icepacks around the p*nis. Although the guy was in pains, i could see the embarrassment written all over his face. I administered vasoconstrictors but we weren't getting the response we wanted fast so we called the urologist and moved him to the theatre in the ER where performed Cavernous aspiration. The procedure simply involves injecting the p*nis with a big syringe and pulling blood out so it will go down. Eventually the penis returned to normal after the procedure and we placed him on painkillers. We also ensured his privacy.


I can only imagine what the boy has been through all his life. Most of them live a greater part of their lives either in and out of the hospital or on constant medications. Usually sicklers are born as a result of either ignorance on the part of the parents who dont know their genotype or selfish decision-making whereby the parents know their genotype but go ahead to marry out of 'love'. 

Although I've seen some dual AS couples who have two or three kids and none is SS, I count those ones lucky. However, sicklers go through a lot of complications such as persistent fever, veno-occlusive disease, acute chest syndrome, osteomyelitis, local or systemic infection, vaso-occlusive crisis, acute splenic sequestration, aplastic crisis, stroke, priapism to mention a few. These complications limits most of them. They hardly engage in physical activities such as sports and most of them finish school after their peers because the spend longer time in the hospital.


However there are sicklers who have fewer crisis and are able to live longer and normal lives so far they take good care of themselves and are financially okay to do that. I'm sure a few of us have friends or a family member with the disease and its our duty to care for them in the best way possible. 

...And if you're a guy or girl in a serious relationship or intending to get married soon, its best you know your genotype soon enough to avoid unnecessary emotional and physical stress in the future.